A dog model was used to measure the hemodynamic changes occurring during acute pancreatitis induced by intraductal injection of fresh trypsin-bile-blood mixture. Pancreatic blood flow was measured with 15-micrometer radioactive microspheres. Measurements of pancreatic adenosine triphosphate (ATP) and creatine phosphate (CP) were made under normal conditions and during acute hemorrhagic pancreatitis. Basal ATP and CP concentrations were 5.82 +/- 0.25 and 5.30 +/- 0.31 mmol/g wet tissue, respectively. Hemorrhagic pancreatitis was characterized by a severe reduction in pancreatic blood flow, followed by a 45% fall of ATP and a 70% lowering of CP. These results suggest that inadequate pancreatic tissue perfusion during acute pancreatitis results in a marked depletion of high-energy phosphate stores. We suspect this energy depletion reflects the progression of the disease from edematous to hemorrhagic pancreatitis and causes irreversible damage of pancreatic tissue.